Rhee Woo-Tack, You Seung-Hoon, Jang Yeon-Gyu, Lee Sang-Youl
Department of Neurosurgery, Gangneung Asan Hospital, College of Medicine, Ulsan University, Gangneung, Korea.
J Korean Neurosurg Soc. 2007 Dec;42(6):495-8. doi: 10.3340/jkns.2007.42.6.495. Epub 2007 Dec 20.
Fractures of lumbo-sacral junction involving bilateral sacral wings are rare. Posterior lumbo-sacral fixation does not always provide with sufficient stability in such cases. Various augmentation techniques including divergent sacral ala screws, S2 pedicle screws and Galveston rods have been reported to improve lumbo-sacral stabilization. Galveston technique using iliac bones would be the best surgical approach especially in patients with bilateral comminuted sacral fractures. However, original Galveston surgery is technically demanding and bending rods into the appropriate alignment is time consuming. We present a patient with unstable lumbo-sacral junction fractures and comminuted U-shaped sacral fractures treated by lumbo-sacro-pelvic fixation using iliac screws and discuss about the advantages of the iliac screws over the rod system of Galveston technique.
累及双侧骶骨翼的腰骶部交界处骨折较为罕见。在这种情况下,后路腰骶部固定并不总能提供足够的稳定性。据报道,包括发散性骶骨翼螺钉、S2椎弓根螺钉和加尔维斯顿棒在内的各种增强技术可改善腰骶部的稳定性。使用髂骨的加尔维斯顿技术将是最佳的手术方法,尤其是对于双侧骶骨粉碎性骨折的患者。然而,原始的加尔维斯顿手术技术要求高,将棒弯曲成合适的角度很耗时。我们介绍了一名通过使用髂骨螺钉进行腰骶骨盆固定治疗的腰骶部交界处不稳定骨折和U形骶骨粉碎性骨折的患者,并讨论了髂骨螺钉相对于加尔维斯顿技术的棒系统的优势。